Primary prevention carried out today can reduce the disease incidence in the future decades. The present disease panorama is the consequence of past asbestos exposure mainly before the 1970s. The peak incidence of asbestos-induced diseases will be reached around 2010 in Finland. The number of asbestos-related premature deaths is at present annually about 150 which exceeds the figure of fatal work accidents. Asbestos-related cancer will increase still for 15-20 years and reach its maximum, about 300 cases, in 2010, and will start to decrease after that. More than 20,000 asbestos-exposed workers have participated in the medical screening and follow-up. The termination of exposure, antismoking campaigns, improved diagnostics and careful attention to compensation issues, as well as other potentials for prevention, were the central issue of the Asbestos Program of the Finnish Institute of Occupational Health. An important objective of research work is to improve early diagnostics, and thereby treatment prospects, in case of asbestos-induced cancers.
OBJECTIVES: The aim of this study was to analyze the incidence of pleural tumors among various categories of Swedish construction workers and to determine to what extent its change over time differs from that of the general male population. METHODS: Traditional methods have been used to study cancer incidence through 1998 in a cohort comprising 370 165 male workers examined in 1971-1992 by Bygghälsan, an organization at the time providing nationwide occupational health service. Incidence was assessed by linkage to the national cancer register. RESULTS: Swedish construction workers, particularly those heavily exposed to asbestos, had an excess incidence of pleural tumors in 1975-1998 [standardized incidence ratio (SIR) 3.16, 95% confidence interval (95% CI) 2.55-3.88]. The excess declined with subsequent follow-up periods and birth cohorts with the exception of the most recent period (SIR 3.83, 95% CI 2.64-5.38) and those borne in the 1930s. CONCLUSIONS: A possible decline in pleural tumors among men following the cessation of asbestos use 25 years earlier in the population at large may not be applicable to an end-user sector like construction work. In occupations charged with repairing and refurbishing work, there may even have been an increase lately.
A review of 398 pleural and peritoneal tumours suggests that diffuse mesothelioma was probably present in 50-60%. However, objective assessment was frequently impeded by serious deficiencies in data or material, which affect the diagnostic grading of cases seen by panels. Observer variation in diagnosis also remains a significant problem. The value of panels for diagnosis could be greatly increased by the provision of adequate data/material and by meetings.
To study the possible work related reasons for the increased incidence of many cancers among seafarers.
A case-control study, nested in a cohort of all male seafarers (n = 30 940) who, according to the files of the Seamen's Pension Fund, had worked on board Finnish ships for any time during the period 1960-80. Cases of cancer of the lung, nervous system, kidney, and pancreas, leukaemia, lymphoma, and all cases histologically defined as mesotheliomas were identified from the Finnish Cancer Registry in 1967-92. The preceding numbers of years at sea in various occupational categories were collected according to the type of ship (dry cargo ship, tanker, passenger vessel, icebreaker, other vessel).
The incidence for lung cancer among engine crew increased with the increase in employment time, the odds ratio (OR) after three years being 1.68 (95% CI 1.17 to 2.41). The OR of lung cancer for deck officers was 0.42 (95% CI 0.29 to 0.61). Deck personnel on icebreakers had a significantly increased risk of lung cancer > or =20 years after first employment (OR 3.41, 95% CI 1.23 to 9.49). The OR for mesothelioma among engine crew with a latency of 20 years was 9.75 (95% CI 1.88 to 50.6). The OR for renal cancer among deck officers after three years employment was 2.15 (95% CI 1.14 to 4.08), but there was no increase by employment time or by latency. A rise of OR for lymphoma was detected among deck personnel on tankers, if the employment had lasted over three years (OR 2.78, 95% CI 0.98 to 7.92). The risk pattern for leukaemia was similar to that of lymphoma, the OR among deck personnel on tankers varying from 2.26 (95% CI 1.01 to 5.06) to 6.86 (95% CI 1.62 to 28.8) depending on the length of employment.
Results indicate that occupational exposures of deck crews on tankers add to their risk of renal cancer, leukaemia, and possibly lymphoma. Engine crews have an asbestos related risk of mesothelioma, and the engine room conditions also seem to increase risk of lung cancer.
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Insulation work has been described as an occupation with high exposure to asbestos. A cohort of members of the Norwegian Trade Union of Insulation Workers (n = 1116), hired between 1930 and 1975, was established. During 2002, the cohort was linked to the Cancer Registry of Norway. The standardized incidence ratio (SIR) of pleural mesothelioma was 12.9 (95% confidence interval [CI] = 6.0-24.6). Two cases with peritoneal mesotheliomas were found (SIR, 14.8; 95% CI = 1.8-53.4). The SIR of lung cancer was 3.0 (95% CI = 2.3-3.8). Four cases of lung cancer were observed among cork workers without any exposure to asbestos, but to cork dust and tar smoke (SIR, 5.3; 95% CI = 1.5-13.6). Our study showed a high risk of mesothelioma and an elevated risk of lung cancer among members of the Trade Union of Insulation Workers.
OBJECTIVES: The incidence of cancer among employees of a Norwegian asbestos-cement factory was studied in relation to duration of exposure and time since first exposure. The factory was active in 1942-1968. Most of the asbestos in use was chrysotile, but for technical reasons 8% amphiboles was added. METHODS: For the identification of cancer cases, a cohort of 541 male workers was linked to the Cancer Registry of Norway. The analysis was based on the comparison between the observed and expected number of cancer cases. Standardized incidence ratios (SIR) and 95% confidence intervals (95% CI) were estimated. Period of first employment, duration of employment, and time since first employment were used as indicators of exposure. Poisson regression analysis was used for the internal comparisons. RESULTS: The standardized incidence ratio was 52.5 (95% CI 31.1-83.0) for pleural mesothelioma, on the basis of 18 cases. The highest standardized incidence ratio was found for workers first employed in the earliest production period (SIR 99.0, 95% CI 51.3-173). No peritoneal mesothelioma was found. The standardized incidence ratio for lung cancer was 3.1 (95% CI 2.14.3), but no dose-response effect was observed. The ratio of mesothelioma to lung cancer cases was 1:2. CONCLUSIONS: This study showed a high incidence of mesothelioma and a high ratio of mesothelioma to lung cancer among asbestos-cement workers. The high incidence of mesothelioma was probably due to the fact that a relatively high proportion of amphiboles was used in the production process.
Tremolite contamination has been proposed as the cause of mesothelioma in workers exposed to commercial chrysotile. The asbestos industry and scientists it has sponsored, for example, have argued that commercial chrysotile does not cause peritoneal mesothelioma.
Case report of peritoneal mesothelioma in a mill worker from a tremolite free Canadian mine.
Reports from pathology and occupational health and safety panels conclude that this mill worker developed work-related peritoneal mesothelioma.
Chrysotile without tremolite can cause peritoneal mesothelioma.
Comment In: Am J Ind Med. 2011 Aug;54(8):64621630296